Chirag Shah, M.D., M.S.C.E., is an Instructor of Medicine in the Pulmonary, Allergy &Critical Care Division at the Hospital of the University of Pennsylvania and a Faculty-Fellow at Penn's Center for Clinical Epidemiology and Biostatistics (CCEB). The career development component of the 5-year training program proposed herein includes a preceptorship with Drs. Stephen Kimmel and Steven Albelda and formal coursework in epidemiology, biostatistics, and translational research. This program of didactic and applied instruction will extend Dr. Shah's prior training, will be directly applicable to the timely completion of his research proposal, and will provide him with the necessary foundation to become an independent translational epidemiologist in the field of sepsis. Despite advances in critical care, both sepsis and acute lung injury (All) continue to have high mortality rates and tremendous acute and long term health care costs. Development of ALI after sepsis worsens clinical outcomes and despite its importance, it is not clearly understood why certain individuals with sepsis develop ALI. The primary hypotheses underlying Dr. Shah's project are that baseline clinical variables related to the patient and the infectious insult are associated with an increased risk for development of ALI after sepsis and that baseline clinical variables and plasma biomarkers of coagulation and inflammation have predictive value for sepsis-relalated ALI. The proposed project, a large-scale prospective cohort study of severe sepsis patients, aims to examine the independent association between clinical variables and the risk of sepsis-related ALI and to develop and validate a model to predict ALI after sepsis using both clinical variables and biomarkers measured in the emergency room. Key interactions between clinical and biological factors in the development of ALI in sepsis patients will also be evaluated. RELEVANCE (See instructions): Greater understanding of the clinical risk factors for ALI after sepsis may inform researchers of the potential mechanisms of these associations. A better ability to predict which sepsis patients will develop ALI will aid physicians in implementing potential therapies earlier, triaging patients more efficiently, allocating ICU resources more appropriately, and risk-stratifying patients for enrollment into clinical intervention trials. (End of Abstract)